QI Nurse Specialist (LVN) (Skilled Nursing Facilities)

Job Description
Department(s): Quality Improvement
Reports to: Manager Quality Improvement
FLSA status: Non-Exempt
Salary Grade: L - $77,000 - $127,094

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Tuesday, October 17, 2023 at 11:59 PM. Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About the Position

The QI Nurse Specialist (LVN) will serve as the quality assurance nurse for skilled nursing facilities (SNF). The incumbent will perform quality assurance visits to all contracted SNFs. The incumbent will act as the liaison for SNFs related to quality activity compliance. The incumbent will also be responsible for the monitoring, maintenance and feedback of SNF quality data for quarterly reports to the Quality Improvement (QI) department.


Duties & Responsibilities:

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Schedules and audits SNF facilities on an annual and on-going basis.
• Maintains electronic SNF files in a professional and accurate manner.
• Conducts ongoing analysis/assessment of operational performance for continuous process improvements, improved efficiency and improved customer satisfaction.
• Establishes and facilitates routine communication and feedback mechanisms with contracted SNFs and report quality assurance findings to operations management.
• Compiles information and prepares reports for QI manager and/or director.
• Integrates data reporting systems to develop and maintain a variety of reports in a format which allows CalOptima Health to see California Department of Public Health (CDPH) audit results and deficiency patterns.
• Ensures compliance with federal, state and other regulatory agency standards.
• Evaluates various types of information for integrity, accuracy and appropriateness.
• Completes other projects and duties as assigned.

Experience & Education:

• Bachelor's degree in Health Services, Public Health, Nursing or related field required.
• Current, unrestricted Licensed Vocational Nurse (LVN) license to practice in the State of California required.
• 3 years of experience in quality management or equivalent experience required.
• Valid driver's license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 60% of the time or more.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

• Experience in a health care delivery system, including health plan, medical group or hospital management.

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical demands: While performing duties of job, employee may be required to move about the organization, as well as to offsite locations. Employee must be able to sit for extended periods of time, as well as work at the computer. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Must also be able to reach with hands and arms and must occasionally lift office supply boxes or laptop case, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, face-to-face interaction. Employee must have means of transportation for offsite travel to health networks/ physician medical groups, local meetings and health care delivery organizations.

• Work Environment: Typical office environment with minimal to moderate noise levels and controlled office temperatures. Offsite work environment varies.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

Job Location: Orange, California
Position Type:

To apply, visit https://jobs.silkroad.com/CalOptima/Careers/jobs/4390

jeid-348e123a1d56c34a89aa93025ed04637